Research Topics
| P E CryerSummaryAffiliation: Washington University School of Medicine Country: USA Publications
Research Grants
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Detail Information
Publications
Minireview: Glucagon in the pathogenesis of hypoglycemia and hyperglycemia in diabetesPhilip E Cryer
Division of Endocrinology, Metabolism, and Lipid Research, Washington University, St Louis, Missouri 63110, USA
Endocrinology 153:1039-48. 2012..If so, abnormal glucagon secretion is involved in the pathogenesis of both hypoglycemia and hyperglycemia in diabetes...
Glucagon and hyperglycaemia in diabetesPhilip E Cryer
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, 660 South Euclid Ave, MO 63110, USA
Clin Sci (Lond) 114:589-90. 2008..Nonetheless, compelling evidence that glucagon contributes to the pathogenesis of hyperglycaemia in diabetes awaits long-term selective reduction of glucagon secretion or action in humans...- Hypoglycemia, functional brain failure, and brain deathPhilip E Cryer
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, Missouri 63110, USA
J Clin Invest 117:868-70. 2007..This finding suggests that, at least in the setting of profound hypoglycemia, therapeutic hyperglycemia should be avoided... - Mechanisms of sympathoadrenal failure and hypoglycemia in diabetesPhilip E Cryer
Division of Endocrinology, Metabolism and Lipid Research, General Clinical Research Center, and Diabetes Research and Training Center, Washington University School of Medicine, St Louis, Missouri 63110, USA
J Clin Invest 116:1470-3. 2006..Thus, hypothalamic urocortin I release during antecedent hypoglycemia is, among other possibilities, a potential mechanism of HAAF... 
Diverse causes of hypoglycemia-associated autonomic failure in diabetesPhilip E Cryer
Division of Endocrinology, Metabolism, and Lipid Research, the General Clinical Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA
N Engl J Med 350:2272-9. 2004- Severe iatrogenic hypoglycemia in type 2 diabetes mellitusPhilip E Cryer
Washington University School of Medicine, St Louis, MO 63109, USA
Nat Clin Pract Endocrinol Metab 3:4-5. 2007 - Hypoglycemia in type 1 diabetes mellitusPhilip E Cryer
Department of Medicine, Washington University School of Medicine, Campus Box 8127, 660 South Euclid Avenue, St Louis, MO 63110, USA
Endocrinol Metab Clin North Am 39:641-54. 2010..Elimination of hypoglycemia from the lives of people with T1DM will likely be accomplished by new treatment methods that provide plasma glucose-regulated insulin replacement or secretion... - Hypoglycemia in diabetes: pathophysiological mechanisms and diurnal variationPhilip E Cryer
Division of Endocrinology, Metabolism and Lipid Research, and the General Clinical Research Center and the Diabetes Research and Training Center, Washington University School of Medicine, St Louis, MO, USA
Prog Brain Res 153:361-5. 2006..Finally, a unifying mechanism of HAAF would need to incorporate the effects of sleep and antecedent exercise which produce a phenomenon similar to hypoglycemia induced HAAF... - Hypoglycaemia: the limiting factor in the glycaemic management of the critically ill?P E Cryer
Division of Endocrinology, Metabolism and Lipid Research Campus Box 8127, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA
Diabetologia 49:1722-5. 2006 - Mechanisms of hypoglycemia-associated autonomic failure and its component syndromes in diabetesPhilip E Cryer
Division of Endocrinology, Metabolism and Lipid Research and General Clinical Research Center, Campus Box 8127, Washington University School of Medicine, 660 South Euclid Ave, St Louis, Missouri 63110, USA
Diabetes 54:3592-601. 2005..Pending the prevention and cure of diabetes, critical fundamental, translational, and outcomes research is needed if we are to eliminate hypoglycemia from the lives of people affected by diabetes... - Forearm norepinephrine spillover during standing, hyperinsulinemia, and hypoglycemiaD S Paramore
Division of Endocrinology, Diabetes, and Metabolism, General Clinical Research Center and the Diabetes Research and Training Center, Washington University School of Medicine, St Louis, Missouri 63110, USA
Am J Physiol 275:E872-81. 1998..Thus these data do not provide direct support for the concept that hypoglycemia per se also stimulates sympathetic neural activity... - Direct muscarinic cholinergic inhibition of hepatic glucose production in humansP J Boyle
Department of Medicine, Washington University School of Medicine, St Louis, Missouri 63110
J Clin Invest 82:445-9. 1988..Thus, particularly if regional neuronal firing occurs, the parasympathetic nervous system may play an important role in human glucoregulatory physiology... - Direct relationship between mononuclear leukocyte and lung beta-adrenergic receptors and apparent reciprocal regulation of extravascular, but not intravascular, alpha- and beta-adrenergic receptors by the sympathochromaffin system in humansS B Liggett
Department of Medicine, Washington University School of Medicine, St Louis, Missouri 63110
J Clin Invest 82:48-56. 1988..These data provide further support for the concept of up regulation, as well as down regulation, of some adrenergic receptor populations during short-term activation of the sympathochromaffin system in humans... - Hypoglycaemia: the limiting factor in the glycaemic management of Type I and Type II diabetesP E Cryer
Division of Endocrinology, Diabetes and Metabolism, Washington University School of Medicine, St Louis, MO 63110, USA
Diabetologia 45:937-48. 2002.... - Hierarchy of physiological responses to hypoglycemia: relevance to clinical hypoglycemia in type I (insulin dependent) diabetes mellitusP E Cryer
Division of Endocrinology, Diabetes and Metabolism, and General Clinical Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
Horm Metab Res 29:92-6. 1997.... - Hypoglycemia-associated autonomic failure in diabetesP E Cryer
Division of Endocrinology, Diabetes and Metabolism, General Clinical Research Center, Washington University School of Medicine, St Louis, Missouri 63110, USA
Am J Physiol Endocrinol Metab 281:E1115-21. 2001.... - Sleep-related hypoglycemia-associated autonomic failure in type 1 diabetes: reduced awakening from sleep during hypoglycemiaSalomon Banarer
Division of Endocrinology, Metabolism, and Lipid Research, General Clinical Research Center, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA
Diabetes 52:1195-203. 2003..This sleep-related hypoglycemia-associated autonomic failure, in the context of imperfect insulin replacement, likely explains the high frequency of nocturnal hypoglycemia in type 1 diabetes... - Renal compensation for impaired hepatic glucose release during hypoglycemia in type 2 diabetes: further evidence for hepatorenal reciprocityHans J Woerle
Department of Medicine, University of Rochester School of Medicine, 601 Elmwood Avenue, Rochester, NY 14642, USA
Diabetes 52:1386-92. 2003.... - Hypoglycemia in type 2 diabetesSalomon Banarer
Department of Medicine, University of Louisville, ACB 3rd Floor, Suite 83G11, 550 Jackson Street, Louisville, KY 40209, USA
Med Clin North Am 88:1107-16, xii-xiii. 2004..Nonetheless, people with diabetes need better treatment regimens... - The pathophysiology of hypoglycaemia in diabetesP E Cryer
Division of Endocrinology, Diabetes and Metabolism, and General Clinical Research Center, Washington University School of Medicine, St. Louis, Missouri 63110, USA
Diabetes Nutr Metab 15:330-3; discussion 362. 2002 - Blood-to-brain glucose transport, cerebral glucose metabolism, and cerebral blood flow are not increased after hypoglycemiaS A Segel
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA
Diabetes 50:1911-7. 2001..They do not exclude regional increments in blood-to-brain glucose transport. Alternatively, the fundamental alteration might lie beyond the blood-brain barrier... - Hypoglycemia-associated autonomic failure in advanced type 2 diabetesScott A Segel
Division of Endocrinology, Diabetes and Metabolism, and the General Clinical Research Center and the Diabetes Research and Training Center, Washington University School of Medicine, St. Louis, Missouri 63110, USA
Diabetes 51:724-33. 2002.... - Hypoglycemia in diabetesPhilip E Cryer
Division of Endocrinology, Diabetes and Metabolism, Washington University School of Medicine, St Louis, Missouri 63110, USA
Diabetes Care 26:1902-12. 2003.... - Effects of glimepiride and glyburide on glucose counterregulation and recovery from hypoglycemiaErvin Szoke
Department of Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA
Metabolism 55:78-83. 2006..This differential effect on insulin secretion may be an important factor in explaining why glyburide causes severe hypoglycemia more frequently than glimepiride... - Insulin resistance in HIV protease inhibitor-associated diabetesK E Yarasheski
Division of Endocrinology, Diabetes, and Metabolism, Washington University Medical School, St Louis, Missouri 63110, USA
J Acquir Immune Defic Syndr 21:209-16. 1999..Fasting hyperglycemia has been associated with HIV protease inhibitor (PI) therapy... - Glucagon, in concert with insulin, supports the postabsorptive plasma glucose concentration in humansSuzanne M Breckenridge
Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St Louis, Missouri 63110, USA
Diabetes 56:2442-8. 2007..Given the interest in glucagon antagonism as a potential treatment of diabetes, we tested the hypothesis that glucagon, in concert with insulin, supports the postabsorptive plasma glucose concentration in humans... - Glucagon supports postabsorptive plasma glucose concentrations in humans with biologically optimal insulin levelsBenjamin A Cooperberg
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, Missouri, USA
Diabetes 59:2941-4. 2010.... - Nocturnal hypoglycemia in type 1 diabetes: an assessment of preventive bedtime treatmentsBharathi Raju
Campus Box 8127, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
J Clin Endocrinol Metab 91:2087-92. 2006..That of terbutaline prevents nocturnal hypoglycemia but causes hyperglycemia the following morning. The efficacy of a lower dose of terbutaline remains to be determined... - Attenuation of counterregulatory responses to recurrent hypoglycemia by active thalamic inhibition: a mechanism for hypoglycemia-associated autonomic failureAna Maria Arbelaez
Campus Box 8127, Washington University School of Medicine, 660 South Euclid Ave, St Louis, MO 63110, USA
Diabetes 57:470-5. 2008..We investigated the role of cerebral mechanisms in HAAF by measuring regional brain activation during recurrent hypoglycemia with attenuated counterregulatory responses and comparing it with initial hypoglycemia in healthy individuals... - Maintenance of the postabsorptive plasma glucose concentration: insulin or insulin plus glucagon?Bharathi Raju
Division of Endocrinology, Metabolism and Lipid Research, Washington Univ School of Medicine, 660 South Euclid Ave, St Louis, MO 63110, USA
Am J Physiol Endocrinol Metab 289:E181-6. 2005..Although the balance of evidence suggests that glucagon is involved in the maintenance of euglycemia, more definitive evidence is needed, particularly in humans... - Beta-cell-mediated signaling predominates over direct alpha-cell signaling in the regulation of glucagon secretion in humansBenjamin A Cooperberg
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, Missouri, USA
Diabetes Care 32:2275-80. 2009..Given evidence of both indirect and direct signaling, we tested the hypothesis that increased beta-cell-mediated signaling of alpha-cells negates direct alpha-cell signaling in the regulation of glucagon secretion in humans... - Symptoms of hypoglycemia, thresholds for their occurrence, and hypoglycemia unawarenessP E Cryer
Division of Endocrinology, Diabetes, and Metabolism, Washington University School of Medicine, St Louis, Missouri, USA
Endocrinol Metab Clin North Am 28:495-500, v-vi. 1999..Thus, patients with recurrent hypoglycemia (e.g., those with tightly controlled diabetes or with an insulinoma) often tolerate abnormally low plasma glucose concentrations without symptoms... - Hypoglycemia risk reduction in type 1 diabetesP E Cryer
Division of Endocrinology, Diabetes and Metabolism, General Clinical Research Center, Diabetes Research and Training Center, Washington University School of Medicine, St Louis, Missouri, USA
Exp Clin Endocrinol Diabetes 109:S412-23. 2001..With this approach the goals of improving glycemic control and minimizing hypoglycemia are not incompatible... - Basal insulin, glucagon, and growth hormone replacementSuzanne M Breckenridge
Division of Endocrinology, Washington University School of Medicine, St Louis, MO 63110, USA
Am J Physiol Endocrinol Metab 293:E1303-10. 2007..Thus, insulin "replacement" doses of 0.20 and even 0.15 mU.kg(-1).min(-1) are excessive, and conclusions drawn from the pancreatic clamp technique using such doses may need to be reassessed... - Insulin reciprocally regulates glucagon secretion in humansBenjamin A Cooperberg
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, Missouri, USA
Diabetes 59:2936-40. 2010..We tested the hypothesis that an increase in insulin per se, i.e., in the absence of zinc, suppresses glucagon secretion during euglycemia and that a decrease in insulin per se stimulates glucagon secretion during hypoglycemia in humans... - Hypoglycemia: still the limiting factor in the glycemic management of diabetesPhilip E Cryer
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, MO 63110, USA
Endocr Pract 14:750-6. 2008..To review the prevalence of, risk factors for, and prevention of hypoglycemia from the perspective of the pathophysiologic aspects of glucose counterregulation in diabetes... - Elevated endogenous cortisol reduces autonomic neuroendocrine and symptom responses to subsequent hypoglycemiaVeronica P McGregor
Division of Endocrinology, Diabetes and Metabolism, General Clinical Research Center, and Diabetes Research and Training Center, Washington University School of Medicine, St. Louis, Missouri 63110, USA
Am J Physiol Endocrinol Metab 282:E770-7. 2002.... - Intraislet hyperinsulinemia prevents the glucagon response to hypoglycemia despite an intact autonomic responseSalomon Banarer
Division of Endocrinology, Diabetes and Metabolism and the General Clinical Research Center and the Diabetes Research and Training Center, Washington University School of Medicine, St. Louis, Missouri 63110, USA
Diabetes 51:958-65. 2002..We conclude that intraislet hyperinsulinemia prevents the glucagon response to hypoglycemia despite an intact autonomic response and a low alpha-cell glucose concentration... - Loss of the decrement in intraislet insulin plausibly explains loss of the glucagon response to hypoglycemia in insulin-deficient diabetes: documentation of the intraislet insulin hypothesis in humansBharathi Raju
Division of Endocrinology, Metabolism and Lipid Research, General Clinical Research Center, Washington University School of Medicine, 660 South Euclid Ave, St. Louis, MO 63110, USA
Diabetes 54:757-64. 2005.... - Hypoglycemia and the sympathoadrenal system: neurogenic symptoms are largely the result of sympathetic neural, rather than adrenomedullary, activationMichael A DeRosa
Campus Box 8127, Washington Univ. School of Medicine, 660 South Euclid Ave, St. Louis, MO 63110, USA
Am J Physiol Endocrinol Metab 287:E32-41. 2004..They also suggest that the plasma NE and hemodynamic responses to hypoglycemia are largely the result of adrenomedullary, rather that sympathetic neural, activation... - Mechanism, temporal patterns, and magnitudes of the metabolic responses to the KATP channel agonist diazoxideBharathi Raju
Division of Endocrinology, Metabolism, and Lipid Research, the General Clinical Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
Am J Physiol Endocrinol Metab 288:E80-5. 2005.... - Cortisol elevations comparable to those that occur during hypoglycemia do not cause hypoglycemia-associated autonomic failureBharathi Raju
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA
Diabetes 52:2083-9. 2003..304 +/- 26 pg/ml) or neurogenic symptom (e.g., final scores of 9.3 +/- 1.1 vs. 13.2 +/- 1.3) responses to subsequent hypoglycemia. Thus, these data do not support the suggestion that cortisol mediates HAAF... - Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice GuidelinePhilip E Cryer
Washington University School of Medicine, St Louis, Missouri 63110, USA
J Clin Endocrinol Metab 94:709-28. 2009..The aim is to provide guidelines for the evaluation and management of adults with hypoglycemic disorders, including those with diabetes mellitus... - Terbutaline and the prevention of nocturnal hypoglycemia in type 1 diabetesBenjamin A Cooperberg
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, Missouri, USA
Diabetes Care 31:2271-2. 2008..We tested the hypothesis that 2.5 mg terbutaline prevents nocturnal hypoglycemia without causing morning hyperglycemia... - Limited impact of vigorous exercise on defenses against hypoglycemia: relevance to hypoglycemia-associated autonomic failureVeronica P McGregor
Division of Endocrinology Diabetes and Metabolism, Washington University School of Medicine, St. Louis, Missouri 63110, USA
Diabetes 51:1485-92. 2002..These data do not support the hypothesis that the cortisol response to hypoglycemia mediates the reduced neurogenic symptom response to subsequent hypoglycemia, another key component of HAAF in type 1 diabetes... - Adrenergic mediation of hypoglycemia-associated autonomic failureRanjani Ramanathan
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, Missouri, USA
Diabetes 60:602-6. 2011.... - Partial inhibition of insulin secretion results in glucose intolerance but not hyperglucagonemiaRanjani P Ramanathan
Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
Diabetes 60:1324-8. 2011.... - Activation of human medial prefrontal cortex during autonomic responses to hypoglycemiaDenise Teves
Division of Endocrinology, Metabolism, and Lipid Research of the Department of Internal Medicine, Washington University School of Medicine, Campus Box 8127, 660 South Euclid Avenue, St. Louis, MO 63110, USA
Proc Natl Acad Sci U S A 101:6217-21. 2004..These results provide evidence that the MPFC participates in the autonomic responses to simple physiological stimuli in humans... - Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of DiabetesPhilip E Cryer
Diabetes Care 30:190-2; author reply 194-6. 2007 - Role of the decrement in intraislet insulin for the glucagon response to hypoglycemia in humansNiyaz R Gosmanov
Carl T Hayden VA Medical Center, 650 E Indian School Road, Phoenix, AZ 85012, USA
Diabetes Care 28:1124-31. 2005..However, in humans this role of decreased intraislet insulin is still unclear... - Multiple defects in counterregulation of hypoglycemia in modestly advanced type 2 diabetes mellitusZarmen Israelian
Department of Endocrinology, Carl T. Hayden VA Medical Center, Phoenix, AZ 85012, and Department of Medicine, University of Rochester School of Medicine, NY 14642, USA
Metabolism 55:593-8. 2006..These include delayed and reduced decreases in insulin secretion, and impaired increases of plasma glucagon and growth hormone... - Increasing the decrement in insulin secretion improves glucagon responses to hypoglycemia in advanced type 2 diabetesZarmen Israelian
Department of Endocrinology, Carl T. Hayden VA Medical Center, Phoenix, AZ 85012, USA
Diabetes Care 28:2691-6. 2005..These findings further support the concept that the impaired counterregulatory glucagon responses in advanced beta-cell failure may at least partially be due to a reduced decrement in insulin secretion...
Research Grants
- ADRENERGIC MECHANISMS IN METABOLIC PATHOPHYSIOLOGYPHILIP CRYER; Fiscal Year: 2007..abstract_text> ..